Dr. Marty Makary’s book titled Unaccountable provides an aggressive recounting of the types of activities that would fall into the Berwick and Hackbarth wasteful spending categories of “Overtreatment,” “Failures of Care Delivery,” and “Failures of Care Coordination.” The picture is not at all pretty. Makary asserts in the Wall St. Journal that preventable “medical mistakes kill enough people each week to fill four jumbo jets.”

For this doctor at least, the answer is transparency – for hospitals, for practices and even for the doctor-patient relationship (right down to open dictation of exam notes with the patient present).

Perhaps Unaccountable will be this decade’s To Err is Human. Perhaps not. Already the author has received considerable push-back alongside of positive press. What should be clear to all of us is that care costs may get all the attention on Capitol Hill, but quality can never be the stepchild of health system improvement. Too many planes-full of lives are at risk each week for it to be anything but the first priority of a medical professional’s focus.